硬性透气性角膜接触镜对圆锥角膜的塑形作用

Effect of rigid gas permeable contact lens on keratoconus

目的:评价硬性透气性角膜接触镜(rigid gas permeable contact lens,RGPCL)长期配戴的安全性和对角膜形态的塑形作用。方法:对圆锥角膜患者选配合适的高透氧RGPCL,分别于配戴前及配戴后12、18个月行角膜曲率计和角膜地形图检查,采集角膜中央散光值、锥顶K值、锥顶偏心距离、SRI、SAI等参数,进行统计学分析。结果:轻度组,配戴RGPCL后角膜散光、锥顶K值、锥顶偏心距离、SRI、SAI较配戴前均有显著性降低(P<0.05);中度组,除12个月时锥顶偏心距离、角膜散光值较配戴前无显著变化外,其他各项参数亦有明显降低,18个月时下降更为明显;重度组,12个月时除锥顶K值显著减小外,其他参数变化不大,18个月时除锥顶偏心距离的变化不显著外,其他参数显著降低。所有患者均未发生并发症。结论:硬性高透气性角膜接触镜长期配戴是安全的,对圆锥角膜形态有一定的塑形作用,从而达到减轻或控制圆锥角膜发展的作用。

Objective： To evaluate the safety and the orthokeratic effect of long-term wearing of rigid gas perme,able contact lens （RGPCL）. Methods： A total of 366 eyes with keratoconus were subjected to wear proper RGPCL. Keratometer and corneal topography were used to determine the central cornea astigmatism, apex K value, apex decentcation distance, SRI and SAI before, 12 and 18 months after wearing RGPCL. Results： Of the slight keratoconus group： the above indexes signitieantly decreased（ P 〈 0.05）. Of the moderate group： the above indexes, except for the apex decentmtion distance signitieantly decreased at 12 months and more evidently at 18 months. Of the severe group, the K value significantly decreased at 12 months and other figures remained unchanged. However, all the indexes significantly decreased except that the apex decentrafion distance remained unchanged at 18 months. No corneal complications were found. Conclusion： Long-term wearing of RGPCL is safe and effect for keratoconus.